South Korean Supreme Court overturns ruling in delayed-test death case

South Korea’s Supreme Court overturned an appellate ruling that had rejected a family’s damages claim over a patient’s death after delayed testing during oxygen treatment. The court sent the case back to Busan District Court, news agencies reported on Oct. 19. It found grounds to recognize medical negligence and a causal link to the death, rejecting the lower court’s view that treatment guidelines were merely recommendations and that negligence had not been established. [ 1 , 2 , 3 , 4 ]

The patient was hospitalized in February 2018 and had chronic obstructive pulmonary disease. Medical staff increased the oxygen supply after oxygen saturation fell to around 80%. High-concentration oxygen treatment began at about 03:50, and consciousness deteriorated around 09:00. An arterial blood-gas test at 16:09 detected excessive carbon dioxide accumulation, about 12 hours and 20 minutes after treatment began. The patient subsequently suffered cardiac arrest and died in March. The COPD guidelines called for blood-gas testing 30 to 60 minutes after starting oxygen therapy. [ 1 , 2 , 4 ]

The Supreme Court said the burden of proving causation should be eased when patients establish negligence and the likelihood that it caused harm. It considered an expert opinion that carbon dioxide accumulation was the most likely cause of deteriorating consciousness and that earlier testing could have allowed an earlier attempt at ventilation. The court found the testing delay could be one cause of the deterioration and that the medical team had not provided evidence sufficient to rebut causation. Yonhap reported that the retrial will reassess damages in light of negligence and the contribution of the patient’s medical history. [ 1 , 2 , 3 , 4 ]